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General NPI Number Information
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NPI Number | 1720970783
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Entity Type | Individual
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Provider Name | MEGAN LOUISE-MARIE WENZEL RADT
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Gender | Female
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 20331 FLANAGAN ROAD
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City | TRABUCO CANYON
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State | CA
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Zip | 92679
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Country | US
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Telephone | 818-582-8832
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Fax | 818-582-8836
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Provider Business Mailing Address
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Address Line | 39842 WESTERN JAY WAY
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City | MURRIETA
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State | CA
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Zip | 92562-4668
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Country | US
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Telephone | 619-352-5838
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | CA
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